title: Regenerative medicine for the treatment of musculoskeletal overuse injuries in competition horses.
abstract: OBJECTIVE
  Tissue repair in musculoskeletal injuries is often a slow and sometimes incomplete process. Regenerative medicine based on the use of growth factors (GFs) and cell therapy is aimed at improving the quality and speed of tendon and ligament healing. The aim of this study was to evaluate the potential for the administration of a combination of autologous platelet-rich plasma (PRP) and freshly isolated bone marrow mononucleated cells (BMMNCs) in 13 competition horses affected by overuse musculoskeletal injuries (suspensory ligament desmopathy and superficial flexor tendinopathy) and refractory to other therapies.
  
  
  METHODS
  After ultrasonographic localisation of the lesion, the autologous BMMNC suspension and PRP were injected directly into the core lesion. BMMNC and platelet count as well as growth factors in PRP were measured to determine factors influencing the clinical outcome.
  
  
  RESULTS
  Horses showed a marked improvement in their degree of lameness and 84.6% were able to return to competition. Among all the factors studied, the platelet concentration predicted the healing time: significantly faster recovery (p = 0.049) was observed in cases of PRP with more than 750 × 10(3)/μl platelets.
  
  
  CONCLUSIONS
  Competition horses are involved in highly demanding activities, thus being a similar model for the high mechanical overload typical of human athletes. The promising results obtained suggest that this combined biological approach may be useful even for the treatment of recalcitrant overuse musculoskeletal injuries in highly demanding patients if the appropriate dose of cells and GFs is applied.
authors.affiliation: Laboratory of Preclinical and Surgical Studies, Research Institute Codivilla-Putti, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136, Bologna, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Torricelli
authors.forename: Milena
authors.initials: M
authors.lastname: Fini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Filardo
authors.forename: Matilde
authors.initials: M
authors.lastname: Tschon
authors.forename: Mario
authors.initials: M
authors.lastname: Pischedda
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pacorini
authors.forename: Elizaveta
authors.initials: E
authors.lastname: Kon
authors.forename: Roberto
authors.initials: R
authors.lastname: Giardino
mesh_terms: D000818:Animals; D001265:Athletic Injuries / Q000628:therapy / Q000662:veterinary*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods / Q000662:veterinary*; D012090:Cumulative Trauma Disorders / Q000000981:diagnostic imaging / Q000628:therapy / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D006736:Horses / Q000502:physiology*; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000637:transplantation; D008297:Male; D017713:Platelet Transfusion / Q000662:veterinary; D053657:Platelet-Rich Plasma / Q000166:cytology; D044968:Regenerative Medicine / Q000379:methods*; D013177:Sports; D023822:Tissue Engineering / Q000662:veterinary*; D014463:Ultrasonography